NCPA - National Center for Policy Analysis

Who Will Decide The Fate Of Premature Babies?

November 29, 2000

Doctors, parents, attorneys and advocates for the disabled are awaiting the decision of a Texas state appeals court involving a hospital's right to determine treatment for a baby born prematurely.

The parents had decided against employing a new medical technology to revive the child, who weighed little more than a pound. But the hospital decided to go ahead with the procedure even though there was a risk the child would grow up disabled. In fact, the child, who is now 10 has grown up blind, brain damaged, speechless, incontinent and paralyzed in three of four limbs.

The ruling will be the first by a state or federal appeals court on who should have the right to decide when to revive a premature baby -- the parents or the doctors? That question is increasingly arising in delivery rooms and courtrooms, as premature babies survive at gestation ages and birth weights unimaginable a decade ago.

  • In 1915, the U.S. infant mortality rate -- those who die in the first year of life -- was 99.9 per 1,000 in that population.
  • As of 1998, it stood at 7.2 per 1,000.

The chances that a premature baby will survive depend on a baby's weight at birth and its gestational age.

  • The mortality rate in the first month of life for babies weighing 1 pound or less at birth is 869.2 per 1,000 live births.
  • The rate steadily drops as birth weight increases.
  • It reaches 2 per 1,000 live births for babies born weighing 5.5 to 6.5 pounds.

The rate of premature births in the U.S. has risen in the past 15 years. Experts say that is due to the increased use of artificial insemination which has produced an explosion in multiple births -- in which babies are often born prematurely. One in nine babies, about 436,000 a year, is born prematurely.

Source: Richard Willing, "Who Decides Whether a Baby Lives or Dies?" USA Today, November 29, 2000.

 

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